Systemic Anti-Cancer Therapy Regimen Library
GU PROS Castration sensitive Metastatic - DOCEtaxel Q3W and darolutamide
Treatment Overview
Usually up to 6 cycles of DOCEtaxel in combination with darolutamide.
Continue darolutamide until disease progression or unacceptable toxicity.
Cycles 1 to 6 - 21 days - DOCEtaxel and darolutamide
Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to DOCEtaxel infusion.
Cycle 7 (and all further cycles) - 28 days - darolutamide continuation
Cycle details
Cycles 1 to 6 - 21 days - DOCEtaxel and darolutamide
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| dexamethasone * | 8 mg Twice daily | oral administration | 0, 1, 2 | |
| DOCEtaxel * | 75 mg/m² | intravenous | 1 | 60 minutes |
| darolutamide | 600 mg Twice daily | oral administration | 1 to 21 | |
| domperidone | 10 mg Three times daily | oral administration | 1 | |
| loperamide | 2 mg | oral administration | 1 |
Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to DOCEtaxel infusion.
Cycle 7 (and all further cycles) - 28 days - darolutamide continuation
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration | 1 to 28 |
Full details
Cycles 1 to 6 - 21 days - DOCEtaxel and darolutamide
Day: 0
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg Twice daily | oral administration |
Instructions:
Take with food. |
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg Twice daily | oral administration |
Instructions:
Take with food. |
|
| DOCEtaxel * | 75 mg/m² | intravenous | 60 minutes |
Instructions:
|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
|
| domperidone | 10 mg Three times daily | oral administration |
Instructions:
When required for nausea and/or vomiting.
|
|
| loperamide | 2 mg | oral administration |
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| dexamethasone * | 8 mg Twice daily | oral administration |
Instructions:
Take with food. |
|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 10
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 11
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 12
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 13
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 14
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 16
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 17
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 18
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 19
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 20
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 21
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Cycle 7 (and all further cycles) - 28 days - darolutamide continuation
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 2
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 3
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 4
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 10
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 11
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 12
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 13
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 14
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 15
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 16
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 17
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 18
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 19
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 20
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 21
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 22
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 23
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 24
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 25
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 26
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 27
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Day: 28
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| darolutamide | 600 mg Twice daily | oral administration |
Instructions:
Take with food. Swallow whole, do not crush or chew. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Diarrhoea risk: | Variable |
| Emetogenicity: | Variable |
| Hypersensitivity / Infusion related reaction risk: | Variable |
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment cycles 1-6 (DOCEtaxel).
Emetogenicity:
- LOW cycles 1-6 (DOCEtaxel).
- MINIMAL to LOW (darolutamide alone): Antiemetics may be required with continuous dosing of oral anti-cancer medicines with MINIMAL to LOW emetic risk; an individualised approach is appropriate.
Hypersensitivity / Infusion related reaction risk: HIGH cycles 1-6 (DOCEtaxel).
References
Pfizer New Zealand Limited. DBL Docetaxel New Zealand Data Sheet 07 August 2020. https://www.medsafe.govt.nz/profs/Datasheet/d/dbldocetaxelinj.pdf (Accessed 26 November 2020)
Bayer New Zealand Limited. Nubeqa (darolutamide) New Zealand Data Sheet 6 August 2024. https://www.medsafe.govt.nz/Profs/Datasheet/n/nubeqatab.pdf (Accessed 14 January 2025).
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.